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Phakic lens implants - Photopic visual acuity versus scotopic visual acuity

David P Austen describes a recent case of fluctuating refractive error of novel origin

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His refraction was:

R: -7.00/-1.00 x 10 = 6/4.5

L: -8.00/-1.00 x 5 = 6/4.5

He had recently had bilateral phakic implants fitted and was very pleased with the outcome.

The figures show the patient's right eye with the lens lined up along 10°. However, he returned and requested spectacles just for driving at night as he felt his vision was not quite good enough.

His refraction was:

R: + 0.50/-1.00 x 60 = 6/4.5

L: + 0.50/-0.25 x 130 = 6/4.5

I dispensed the full prescription, but he soon came back saying his vision was worse for night driving with the new spectacles.

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